Off the Charts

Here are a few items of interest on today’s Web as these huge wet snowflakes actually start to accumulate on rooftops here in NYC and the horizon (New Jersey, that is, across the thin wedge of the Hudson River you can see from AJN offices) closes steadily in:

Kim at Emergiblog has a nice post dealing with changing her mind about whether or not she wanted to get a BSN.

And this post by Anne Dabrow Woods at In the Round (excerpted below) got our attention for its honesty about the difference between treating a condition in the hospital and treating it at home in a family member—and also because it put a human face on an article we ran in our February issue about ostomy complications and management.

My oldest daughter was diagnosed with ulcerative colitis when she was 7 years old and despite aggressive treatment for her disease; she required a total colectomy, temporary ileostomy, and an ileo-anal anastamosis when she was 12. As a nurse I thought I was equipped to care for her ileostomy; was I ever wrong. I had experience taking care of hospitalized patients with ostomies, but I quickly learned caring for someone who is active is a totally different story.

In his most recent post, Anonymous Doc is as usual thoughtful and honest (except for that anonymity thing, of course . . . which does, whatever its drawbacks, kind of free him up as a writer). He moves from considering the fairly superficial question of whether it’s appropriate for him to suggest that a sweating patient take off her sweater to some related but perhaps deeper questions:

More than once, I’ve made a comment that’s probably too casual when we’re talking about running some blood work. Like, “I hope they don’t find [whatever].” As a fellow human being, I hope they don’t. As a doctor, am I supposed to acknowledge hope, and uncertainty? Shouldn’t I say something like “there’s an x% chance they’ll find [whatever],” or say nothing at all, and wait until they find what they’re going to find, and not scare the patient needlessly? I don’t know. They don’t train us (much) in actual patient interaction. We’re expected to pick it up, to know things automatically.

Also of significance this week, the House passed legislation to “strip health insurers of their federal antitrust exemption.” In other words, insurers may soon have to do a better job pleasing customers rather than abusing them—or face stiff competition from competitors who are willing to do so instead.